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Colorectal cancer (CRC) is the most common tumor and the second leading cause of death in the Western world. The decrease in incidence and mortality by CRC in the population undergoing screening has been observed. Colonoscopy is the recommended method for detecting tumors in early stages, as well as identifying and resecting adenomatous polyps, which are the precursor lesions of most CRCs. Colonoscopy should be of high quality to decrease incidence and mortality by CRC and avoid interval cancer. The literature shows that colonoscopy does not prevent right colon lesions in the same way as the left colon lesions, with most of the interval cancers located in the right colon. Studies published so far show an increase in the adenomas detection rate (ADT) in the right colon in the second visualization of this segment and an increase between 2 and 10% if this second examination is performed with the proximal retroflexion maneuver.Retroflexion is a safe maneuver in expert endoscopists. The aim of our study is to evaluate the ADT in the right colon by means of a second visualization by performing proximal retroflexion or second frontal visualization at random in the CCR screening population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| proximal retroflexion | Experimental | Procedure: The endoscopy explore right colon with frontal view and a second look with proximal retroflexion |
|
| frontal view of right colon | Active Comparator | Procedure: The endoscopy explore right colon with frontal view and frontal view |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Proximal retroflexion | Procedure | The investigator explore twice right colon, first front view and second forward viewing or proximal retroflexion depends on randomization |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proximal retroflexion improve adenoma detection rate in colorectal cancer screening | Determine whether to perform retroflexion proximal improves adenoma detection rate in the right colon versus forward vision in population screening colorectal cancer with medium risk with immune blood test positive stool | through study completion, an average of 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Second look for right colon improve adenoma detection rate | Determine if a second look: retroflexion proximal or forward view improve adenoma detection rate | through study completion, an average of 1 year |
| Rate of retroflexion related adverse events |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mª Henar Núñez Rodriguez | Hospital del Rio Hortega Valladolid, Spain | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Universitario Rio Hortega | Valladolid | 47012 | Spain |
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| Frontal view | Procedure | The investigator explore twice right colon with frontal viewing |
|
| through study completion, an average of 1 year |
| Rate of retroflexion proximal adverse events with a pediatric colonoscopy | through study completion, an average of 1 year |
| Pre-procedure factors | To analyze pre-procedure factors that may influence the prevalence of precursor lesions in the colon: age, sex, race, alcohol, smoking habit and the value of SOH, in which more detailed explorations should be performed using proximal retroflexion | through study completion, an average of 1 year |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |